EP1560553A2 - Regulation de l'expression du gene de l'aggrecane au moyen de signaux electriques et electromagnetiques specifiques et selectifs - Google Patents

Regulation de l'expression du gene de l'aggrecane au moyen de signaux electriques et electromagnetiques specifiques et selectifs

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Publication number
EP1560553A2
EP1560553A2 EP03798741A EP03798741A EP1560553A2 EP 1560553 A2 EP1560553 A2 EP 1560553A2 EP 03798741 A EP03798741 A EP 03798741A EP 03798741 A EP03798741 A EP 03798741A EP 1560553 A2 EP1560553 A2 EP 1560553A2
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EP
European Patent Office
Prior art keywords
specific
signal
cartilage
aggrecan
gene expression
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Granted
Application number
EP03798741A
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German (de)
English (en)
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EP1560553B1 (fr
EP1560553A4 (fr
Inventor
Carl T. Brighton
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University of Pennsylvania Penn
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University of Pennsylvania Penn
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Publication of EP1560553A4 publication Critical patent/EP1560553A4/fr
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    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/63—Introduction of foreign genetic material using vectors; Vectors; Use of hosts therefor; Regulation of expression
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/326—Applying electric currents by contact electrodes alternating or intermittent currents for promoting growth of cells, e.g. bone cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N13/00—Treatment of microorganisms or enzymes with electrical or wave energy, e.g. magnetism, sonic waves
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/63—Introduction of foreign genetic material using vectors; Vectors; Use of hosts therefor; Regulation of expression
    • C12N15/67—General methods for enhancing the expression

Definitions

  • the present invention is directed to a method of regulating aggrecan gene expression in cartilage cells via the application of fields generated by specific and selective electric and electromagnetic signals for the treatment of injured or diseased articular cartilage, as well as a device for generating such signals.
  • Osteoarthritis also known as degenerative joint disease, is characterized by degeneration of articular cartilage as well as proliferation and remodeling of subchondral bone. The usual symptoms are stiffness, limitation of motion, and pain. Osteoarthritis is the most common form of arthritis, and prevalence rates increase markedly with age. It has been shown that elderly patients with self-reported osteoarthritis visit doctors twice as frequently as their unaffected peers. Such patients also experience more days of restricted activity and bed confinement compared to others in their age group. In one study, the majority of symptomatic patients became significantly disabled during an 8-year follow-up period. Massardo et al., Ann Rheum
  • Nonsteroidal anti-inflammatory drugs remain the primary treatment modality for osteoarthritis. It is unknown whether the efficacy of NSAIDs is dependent upon their analgesic or anti-inflammatory properties or the slowing of degenerative processes in the cartilage. There is also a concern that NSAIDs may be deleterious to patients. For example, NSAIDs have well known toxic effects in the stomach, gastrointestinal tract, liver and kidney. However, aspirin inhibits proteoglycan synthesis and normal cartilaginous repair processes in animals. One study in humans suggested that indomethacin might accelerate breakdown of hip cartilage. All adverse effects appear more commonly in the elderly - the very population most susceptible to osteoarthritis.
  • Bone demineralizes and becomes abnormally rarefied.
  • Bone comprises an organic component of cells and matrix as well as an inorganic or mineral component.
  • the cells and matrix comprise a framework of collagenous fibers that is impregnated with the mineral component of calcium phosphate (85%) and calcium carbonate (10%) that imparts rigidity to the bone.
  • calcium phosphate 85%
  • calcium carbonate 85%
  • osteoporosis is generally thought as afflicting the elderly, certain types of osteoporosis may affect persons of all ages whose bones are not subject to functional stress. In such cases, patients may experience a significant loss of cortical and cancellous bone during prolonged periods of immobilization.
  • the present invention relates to regulating the aggrecan gene expression in cartilage cells via the application of fields generated by specific and selective electric and/or electromagnetic signals.
  • the optimal signal for up-regulating aggrecan mR ⁇ A in articular cartilage chondrocytes was discovered.
  • the optimal signal generated a capacitively coupled electric field with an amplitude of 20 mN/cm, a duration of 30 minutes, a duty cycle of 50%, a frequency of 60 kHz, and a sine wave configuration.
  • the present invention relates to up-regulating aggrecan gene expression in cartilage cells via the application of fields generated by such signals.
  • methods are provided to specifically and selectively up-regulate the gene expression of aggrecan mRNA with capacitively coupled electric fields, electromagnetic fields, or combined fields.
  • Osteoarthritis, rheumatoid arthritis, cartilage injury, cartilage defects, and the like are treated with a capacitively coupled electric field of about 20 mN/cm with an electric field duration of about 30 minutes, an electric field amplitude of about 10-20 mN/cm, a frequency of about 60 kHz, a duty cycle of about 50%, and a sine wave configuration that causes the expression of aggrecan mR ⁇ A to be up-regulated.
  • a "specific and selective" signal is a signal that has predetermined characteristics of amplitude, duration, duty-cycle, frequency, and waveform that up-regulates the expression of the aggrecan gene (specificity). This allows one to choose different signals to up-regulate aggrecan gene expressions in order to achieve a given biological or therapeutic response (selectivity).
  • the invention further relates to devices employing the methods described herein to generate specific and selective signals that create fields to up-regulate the expression of the aggrecan gene.
  • the present invention relates to methods and devices for the treatment of osteoarthritis, rheumatoid arthritis, cartilage injury, and cartilage defects.
  • the method of the invention also includes the methodology for determining the "specific and selective" signal for the aggrecan gene by methodically varying the duration of a starting signal known to increase or suspected to increase cellular production of aggrecan. After selecting the optimal duration, the amplitude of the signal is varied for the optimal duration of time as determined by the gene expression of aggrecan. The duty cycle, frequency, and waveform are varied methodically while keeping the other signal characteristics constant. This process is repeated until the optimal signal is determined that produces the greatest increase in the expression of aggrecan .
  • Figure 1 is a graphic representation of aggrecan mRNA expression when articular cartilage chondrocytes are exposed to a 20 mN/cm capacitively coupled electric field for various time durations. As indicated, the optimum aggrecan mRNA production occurred with a signal of 30 minutes duration.
  • Figure 2 is a graphic representation of aggrecan mRNA expression when articular cartilage chondrocytes are exposed to various amplitudes of a capacitively coupled field of 30 minutes duration. As indicated, the optimum production of aggrecan mRNA occurred with a signal producing an electric field amplitude of 10-20 mV/cm.
  • Figure 3 is a graphic representation of aggrecan mRNA expression when articular cartilage chondrocytes are exposed to a capacitively coupled electric field of various duty cycles with a duration of 30 minutes (on time) at 20 mN/cm electric field amplitude. As indicated, the optimum duty cycle is 50%.
  • Figure 4 is a graphic representation of articular cartilage chondrocytes exposed to a capacitively coupled electric field of various frequencies of 30 minutes duration (on time) at 20 mN/cm electric field amplitude with a 50% duty cycle. As indicated, the optimum frequency is 60 kHz.
  • Figure 5 is a graphic representation of articular cartilage chondrocytes grown for 7 days in culture and then exposed to the optimal capacitively coupled electric field of 20 mN/cm, 50% duty cycle (30 minutes duration on time), at a frequency of 60 kHz, and a sine wave configuration. No interleukin was present in the media of the cultures and, as indicated, hexosamine showed a 3.5 fold increase.
  • Figure 6 is a graphic representation of articular cartilage chondrocytes grown for 7 days then exposed to the optimal capacitively coupled electric field of 20 mN/cm, 50% duty cycle (30 minutes duration on time), at a frequency of 60 kHz, and a sine wave configuration.
  • Interleukin (10 ug/ml) or IL- ⁇ i was added to the media at day 7. As indicated, hexosamine showed a 3.5 fold increase despite the presence of interleukin in the media of the cultures.
  • Figure 7 is a diagram illustrating a device for the treatment of osteoarthritis of the knee, in accordance with a preferred embodiment of the present invention.
  • the present invention is based on the discovery that the expression of certain genes can be regulated by the application of fields generated by specific and selective electric and/or electromagnetic signals.
  • a specific electric and/or electromagnetic signal that generates a field for regulating each gene in bone, cartilage and other tissue cells and that these specific signals are capable of specifically and selectively regulating the genes in such cells.
  • gene expression governing the growth, maintenance, repair, and degeneration or deterioration of tissues or cells can be regulated in accordance with the invention via the application of fields generated by specific and selective electric and /or electromagnetic signals so as to produce a salutary clinical effect.
  • Such discoveries are useful in the development of treatment methods that target certain medical conditions including bone fractures and defects, osteoarthritis, osteoporosis, cancer and other diseases, as well as for developing devices employing such methods.
  • the phrase "signal” is used to refer to a variety of signals including mechanical signals, ultrasound signals, electromagnetic signals and electric signals output by a device. It is to be understood that the term “field” as used herein refers to an electrical field within targeted tissue, whether it is a combined field or a pulsed electromagnetic field or generated by direct current, capacitive coupling or inductive coupling.
  • the phrase “remote” is used to mean acting, acted on or controlled from a distance.
  • Remote” regulation refers to controlling the expression of a gene from a distance.
  • To provide “remotely” refers to providing from a distance. For example, providing a specific and selective signal from a remote source can refer to providing the signal from a source at a distance to tissue or a cell or from a source outside of or external to the body.
  • specific and selective signal means a signal that produces an electric field that has predetermined characteristics of amplitude, duration, duty-cycle, frequency, and waveform that up-regulate or down-regulate a targeted gene or targeted functionally complementary genes (specificity). This allows one to choose different "specific and selective" signals to up-regulate or down-regulate various gene expressions in order to achieve a given biological or therapeutic response (selectivity).
  • regulate means to control gene expression. Regulate is understood to include both up-regulate and down-regulate. Up-regulate means to increase expression of a gene, while down-regulate means to inhibit or prevent expression of a gene.
  • “Functionally complementary” refers to two or more genes whose expressions are complementary or synergistic in a given cell or tissue.
  • tissue refers to an aggregate of cells together with their extracellular substances that form one of the structural materials of a patient.
  • tissue is intended to include muscle and organ tissue as well as bone or cartilage tissue. Also, the term “tissue” as used herein may also refer to an individual cell.
  • Patient refers to an animal, preferably a mammal, more preferably a human.
  • the present invention provides treatment methods and devices that target certain tissues, cells or diseases.
  • the gene expression associated with the repair process in injured or diseased tissues or cells can be regulated by the application of fields generated by electric signals that are specific and selective for the genes to be regulated in the target tissues or cells.
  • Gene expression can be up-regulated or down- regulated by the application of signals that are specific and selective for each gene or each set of complementary genes so as to produce a beneficial clinical effect.
  • a particular specific and selective signal may create an electric field that up- regulates a certain desirable gene expression, while the same or another particular specific and selective signal may create an electric field that down-regulates a certain undesirable gene expression.
  • a certain gene may be up-regulated by a field generated by one particular specific and selective signal and down-regulated by a field generated by another specific and selective signal.
  • certain diseased or injured tissues can be targeted for treatment by regulating those genes governing the growth, maintenance, repair, and degeneration or deterioration of the tissues.
  • the methods and devices of the present invention are based on identifying those signals that generate fields that are specific and selective for the gene expression associated with certain targeted diseased or injured tissue.
  • electricity in its various forms e.g., capacitive coupling, inductive coupling, combined fields
  • the duration of time exposed to electricity can also influence the capability of electricity to specifically and selectivity regulate gene expression in targeted tissues or cells in a patient's body.
  • Specific and selective signals may generate electric fields for application to each gene systematically until the proper combination of frequency, amplitude, waveform, duty cycle, and duration is found that provides the desired effect on gene expression.
  • a variety of diseased or injured tissues or disease states can be targeted for treatment because the specificity and selectivity of an electric field for a certain gene expression can be influenced by several factors.
  • an electrical field of appropriate frequency, amplitude, waveform and/or duty cycle can be specific and selective for the expression of certain genes and thus provide for targeted treatments.
  • Temporal factors e.g., duration of time exposed to the electrical field
  • the regulation of gene expression may be more effective (or made possible) via the application of an electrical field for a particular duration of time.
  • the present invention provides for varying the frequency, amplitude, waveform, duty cycle and/or duration of application of an electric field until the electric field is found to be specific and selective for certain gene expressions in order to provide for treatments targeting a variety of diseased or injured tissue or diseases.
  • the present invention can provide for targeted treatments because it is possible to regulate expression of certain genes associated with a particular diseased or injured tissue via the application of fields generated by specific and selective signals of appropriate frequency, amplitude, waveform and/or duty cycle for an appropriate duration of time.
  • the specificity and selectivity of a signal generating an electrical field may thus be influenced so as to regulate the expression of certain genes in order to target certain diseased or injured tissue or disease states for treatment.
  • the present invention provides for the targeted treatment of osteoarthritis, rheumatoid arthritis, cartilage injury, and cartilage defects.
  • the present invention also provides a device that includes a source of at least one signal specific and selective for aggrecan gene expression.
  • the devices of the present invention can provide for the production of such signals for application to cartilage cells by at least one electrode adapted to apply the field generated by the specific and selective signal.
  • the device of the present invention is capable of applying a field generated by specific and selective signals directly to diseased or injured tissue and/or to the skin of a patient.
  • the device of the present invention may also provide for the remote application of specific and selective fields (e.g., application of a field at a distance from diseased or injured tissue), although it will be appreciated that capacitively coupled devices must touch the subject's skin.
  • the device of the present invention may include means for attaching the electrodes to the body of a patient in the vicinity of injured or diseased tissue.
  • self-adherent conductive electrodes may be attached to the skin of the patient on both sides of a knee joint afflicted with osteoarthritis as shown in Figure 7.
  • the device 10 of the present invention may include self-adherent electrodes 12 for attaching the device 10 to the body of a patient.
  • the device 10 of the present invention may include electrodes 12 attached to a power unit 14 that has a NELCRO® patch 16 on the reverse side such that the power unit 14 can be attached to a NELCRO® strap (not shown) fitted around the calf, thigh or waist of the patient.
  • the device 10 of the present invention can be employed in a variety of ways.
  • the device 10 may be portable or may be temporarily or permanently attached to a patient's body.
  • the device 10 of the present invention is preferably non-invasive.
  • the device 10 of the present invention may be applied to the skin of a patient by application of electrodes adapted for contact with the skin of a patient for the application of fields generated by the predetermined specific and selective signals.
  • Such signals may also be applied via coils in which time varying currents flow, thus producing specific and selective electromagnetic fields that penetrate the tissue.
  • the device 10 of the present invention may also be capable of implantation in a patient, including implantation under the skin of a patient.
  • Cartilage growth and repair can be stimulated via signals specific and selective for the regulation of expression of aggrecan in cartilage cells so as to stimulate articular cartilage repair in osteoarthritis patients.
  • the methods of the present invention can provide for the up-regulation of aggrecan genes that repair cartilage.
  • a variety of cartilage cells can be targeted by the methods of the present invention including articular chondrocytes and including articular cartilage, hyaline cartilage, and growth plate cartilage.
  • the example below further illustrates that the method of the present invention provides for the regulation of gene expression in articular chondrocytes.
  • fetal articular chondrocytes have been exposed to a capacitively coupled 60 kHz electrical field of 20 mN/cm for 0.5, 2.0, 6.0 and 24.0 hours.
  • a statistically significant incorporation of 35 SO 4 /ug D ⁇ A (indicating significant proteoglycan synthesis) was found after only 0.5 hours of stimulation.
  • An identical experiment was repeated and the levels of aggrecan mR ⁇ A, the messenger for the major cartilage proteoglycan, monitored. After only 0.5 hours of electrical stimulation there was a significant increase (almost 100%) in aggrecan mR ⁇ A.
  • temporal factors may influence the specificity and selectivity of a signal that generates electric fields for regulating gene expression in articular chondrocytes.
  • cartilage diseases and injuries may be targeted for treatment via the method of the present invention.
  • the devices of the present invention can be provided in a variety of forms including a capacitively coupled power unit with programmed multiple switchable specific and selective signals for application to one pair or to multiple pairs of electrodes, electromagnetic coils attached to a power unit with switchable multiple specific and selective signals, and an ultrasound stimulator with a power supply for generating specific and selective signals.
  • a capacitively coupled power unit with programmed multiple switchable specific and selective signals for application to one pair or to multiple pairs of electrodes electromagnetic coils attached to a power unit with switchable multiple specific and selective signals
  • an ultrasound stimulator with a power supply for generating specific and selective signals.
  • device preference is based on patient acceptance and patient compliance.
  • the smallest and most portable unit available in the art at the present time is a capacitive coupling unit; however, patients with extremely sensitive skin may prefer to use inductive coupling units.
  • ultrasound units require the most patient cooperation but may be desirable for use by certain patients.
  • Chondrocyte cultures were prepared from fetal bovine articular cartilage. Chondrocytes (5 x 10 5 cells/cm 2 ) were plated onto specially modified Cooper dishes. The cells were grown to seven days with the medium changed just prior to beginning of the experimental condition. The experimental cell cultures throughout these studies were subjected to a capacitively coupled 60 kHz sine wave signal electric field with an output of 44.81 volts peak to peak. This produced a calculated-field strength in the culture medium in the dishes of 20 mN/cm with a current density of 300 ⁇ A/cm 2 . Control cell culture dishes were identical to that of the stimulated dishes except that the electrodes were not connected to a function generator.
  • Total R ⁇ A was isolated using TRIzol, according to the manufacturer's instructions, and reversed transcription using Superscript II reverse transcriptase was performed. Oligonucleotide primers to be used in the competitive PCR technique were selected from published cDNA sequences. Quantitative analysis of PCR products was performed using Scionlmage software.
  • the optimal signal for the desired gene regulation was found systematically as follows.
  • An electrical signal known to increase (or even just suspected to increase) cellular production of a given protein is taken as the starting signal for determining the specific signal for generating the field for the gene expression (mRNA) of that protein.
  • a dose-response curve is first performed by varying the duration of the signal while holding all the other signal characteristics constant (amplitude, duty-cycle, frequency, and waveform) ( Figure 1). This determines the optimal duration of the starting signal for the gene expression of that protein.
  • a second dose-response curve is performed by varying the field amplitude for the optimal duration of time ( Figure 2). This determines the optimal field amplitude for the optimal duration of time as determined by the gene expression of the protein of interest.
  • a third dose-response curve is then performed, this time varying the duty-cycle from 100% (constant) to 1% or less while holding the optimal amplitude and other signal characteristics constant (Figure 3).
  • a dose-response is repeated a fourth time (varying frequency) ( Figure 4) and a fifth time (varying waveform) each time keeping the other signal characteristics constant.
  • Protein expression may be determined by any method known in the art, such as reverse transcriptase PCR, Northern analysis, immunoassays, and the like. Aggrecan production by articular chondrocytes
  • Figure 1 is a graphic representation of aggrecan mR ⁇ A expression when articular cartilage chondrocytes (attomole per ⁇ l) are exposed to a 20 mN/cm capacitively coupled electric field for various time durations (0.5, 2, 6, and 24 hours). As indicated, the optimum aggrecan mR ⁇ A production (almost a two-fold increase) occurred with a signal of 30 minutes duration.
  • Figure 2 is a graphic representation of aggrecan mR ⁇ A expression when articular cartilage chondrocytes (attomole per ⁇ l) are exposed to various amplitudes (1, 5, 10, 20, and 40 mN/cm) of a capacitively coupled field of 30 minutes duration. As indicated, the optimum production of aggrecan mR ⁇ A occurred with a signal producing an electric field amplitude of 10-20 mN/cm.
  • Figure 3 is a graphic representation of aggrecan mR ⁇ A expression when articular cartilage chondrocytes (attomole per ⁇ l) are exposed to a capacitively coupled electric field of various duty cycles (6.7%, 12.5%, 50%, 75%, and 100%) with a duration of 30 minutes (on time) at 20 mN/cm electric field amplitude. As indicated, the optimum duty cycle is 50%.
  • Figure 4 is a graphic representation of articular cartilage chondrocytes (attomole per ⁇ l) exposed to a capacitively coupled electric field of various frequencies (30kHz, 60 kHz, and 120 kHz) of 30 minutes duration (on time) at 20 mN/cm electric field amplitude with a 50% duty cycle. As indicated, the optimum frequency is 60 kHz.
  • Figure 5 is a graphic representation of articular cartilage chondrocytes grown for 7 days in culture and then exposed to the optimal capacitively coupled electric field of 20 mN/cm, 50% duty cycle (30 minutes duration on time), at a frequency of 60 kHz, and a sine wave configuration. The chondrocytes were exposed to this field for 1 hour per day for 7 days. Control chondrocytes were grown under the same conditions but were not exposed to any electric stimulation. No interleukin, a cytokine that degradates articular cartilage, was present in the media of the cultures.
  • hexosamine a protein whose synthesis is stimulated and regulated by aggrecan mRNA and is the main constituent of proteoglycan, showed a 3.5 fold increase when exposed to the applied electric field as compared to the control chondrocytes that were not exposed to the electric field.
  • Figure 6 is a graphic representation of articular cartilage chondrocytes grown for 7 days then exposed to the optimal capacitively coupled electric field of 20 mN/cm, 50% duty cycle (30 minutes duration on time), at a frequency of 60 kHz, and a sine wave configuration.
  • Interleukin (10 ug/ml) or IL- ⁇ i was added to the media at day 7.
  • the chondrocytes were exposed to this field for 1 hour per day for 7 days.
  • Control chondrocytes were grown under the same conditions with interleukin in the media but were not exposed to any electric stimulation.
  • hexosamine a protein whose synthesis is stimulated and regulated by aggrecan mRNA and is the main constituent of proteoglycan, still showed a 3.5 fold increase when exposed to the applied electric field as compared to the control cultures that were not exposed to the electric field.
  • FIG. 7 illustrates a device 10 in accordance with the present invention that is used to treat a patient with osteoarthritis of the knee.
  • two circular, soft conductive, self-adherent electrodes 12 are placed on the skin on either side of the knee at the level of the joint line.
  • the electrodes 12 are attached to a power unit 14 that has a NELCRO® patch 16 on the reverse side such that the power unit 14 can be attached to a NELCRO® strap (not shown) fitted around the calf, thigh or waist.
  • the electrodes 12 may be placed on the skin before the patient goes to bed each evening or any other convenient time. Of course, other suitable types of electrodes 12 may also be used.
  • the power unit 14 is preferably small (e.g., 6-8 ounces) and powered by a standard 9-volt battery to emit a 5-volt peak-to-peak, 6-10 mAmp, 20 mN/cm, 60 kHz sine wave signal to the electrodes 12 placed on the skin.
  • this signal is provided approximately 30 minutes per day with the proper duty cycle (50%), it has been shown to significantly up-regulate genes encoding aggrecan. This treatment should prevent or minimize further articular cartilage deterioration as well as to heal articular cartilage that already is damaged or degenerated.
  • the example described above demonstrates that the expression of the aggrecan gene may be significantly up-regulated to increase the production of proteoglycan in articular cartilage so as to treat arthritis (both osteoarthritis and rheumatoid arthritis), cartilage injury, and cartilage defects.
  • Proteoglycan, along with Type II collagen, is the main constituent of articular cartilage and is degradated and destroyed early in the development of arthritis.
  • the present invention clearly shows that the optimal electric field described in the example can very significantly up-regulate aggrecan mR ⁇ A and, hence, increase proteoglycan synthesis, even in the presence of IL- ⁇ i.
  • the optimal field described herein can be applied to any joint via two or more appropriate surface electrodes, in pairs or strips, incorporated in garments, braces, wraps, or casts, and delivered by means of capacitive coupling, inductive coupling

Abstract

L'invention concerne des procédés et des dispositifs destinés à réguler l'expression du gène de l'aggrécane dans des cellules cartilagineuses par application de champs produits par des signaux électriques et électromagnétiques, spécifiques et sélectifs dans le traitement de cartilage articulaire malade ou blessé. Par expression génique, on entend la régulation montante ou descendante du procédé par lequel des parties spécifiques (gène) du génome humain (ADN) sont transcrits en ARNm et ultérieurement traduits en protéine. L'invention concerne également des procédés et des dispositifs destinés au traitement ciblé de tissu cartilagineux blessé ou malade consistant à générer des signaux électriques et électromagnétiques, spécifiques et sélectifs produisant des champs optimisés pour l'expression génique de l'aggrécane et exposant le tissu cartilagineux à des champs produits par les signaux sélectifs et spécifiques de manière à réguler l'expression génique de l'aggrécane dans ces tissus cartilagineux. Les procédés et les dispositifs résultant de cette invention sont utiles dans le traitement ciblé de l'ostéo-arthrite, de la polyarthrite rhumatoïde, des lésions et des défauts du cartilage.
EP03798741.9A 2002-09-26 2003-09-24 Régulation de l'expression du gène de l'aggrécane au moyen de signaux électriques et electromagnétiques spécifiques et sélectifs Expired - Lifetime EP1560553B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US10/255,241 US7374916B2 (en) 2000-02-23 2002-09-26 Regulation of aggrecan gene expression using specific and selective electrical and electromagnetic signals
US255241 2002-09-26
PCT/US2003/030333 WO2004029210A2 (fr) 2002-09-26 2003-09-24 Regulation de l'expression du gene de l'aggrecane au moyen de signaux electriques et electromagnetiques specifiques et selectifs

Publications (3)

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EP1560553A2 true EP1560553A2 (fr) 2005-08-10
EP1560553A4 EP1560553A4 (fr) 2007-09-12
EP1560553B1 EP1560553B1 (fr) 2017-01-25

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US (1) US7374916B2 (fr)
EP (1) EP1560553B1 (fr)
JP (1) JP4344321B2 (fr)
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US20030125769A1 (en) 2003-07-03
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MXPA05003259A (es) 2005-09-12
CN1694674A (zh) 2005-11-09
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US7374916B2 (en) 2008-05-20
BR0314807A (pt) 2005-08-09
CA2500212A1 (fr) 2004-04-08
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